Nearly 70% of patients with inflammatory rheumatic disease miss physical activity targets
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Key takeaways:
- Moderate-vigorous physical activity criteria were not met by 68.4% of people with IRDs.
- Greater overall physical activity was correlated with reduced fatigue.
More than two-thirds patients with inflammatory rheumatic diseases fall short of physical activity targets for moderate-to-vigorous exercise, according to data published in Rheumatology Advances in Practice.
The study, based on data from thigh-worn accelerometers, also found that higher levels of objectively measured physical activity correlated with lower levels of fatigue among patients with rheumatoid arthritis and other inflammatory rheumatic diseases.
“Despite recent changes in [inflammatory rheumatic disease (IRD)] treatment, the symptom of fatigue remains highly prevalent,” Stuart R. Gray, PhD, professor of muscle and metabolic health at the University of Glasgow, and colleagues wrote. “Approximately 80% of people with IRDs report significant fatigue, and 70% consider the symptom to be as great a burden as pain.
“How established objective measures of overall physical activity (eg, step count), along with complementary dimensional metrics (eg, intensity gradient), are associated with fatigue in people with IRDs remains to be established,” they added.
Gray and colleagues had previously conducted a study called Lessening the Impact of Fatigue in IRDs (LIFT), in which a personalized exercise program resulted in “sustained” reductions to the severity and impact of fatigue among participants with IRDs, they wrote. In a sub-study, participants were also given thigh-worn accelerometers that collected objective physical activity metrics, such as step count.
“This builds on our previous work in the LIFT trial where we showed that a personalized exercise program reduced fatigue, and so we wanted to explore this further,” Gray told Healio.
To assess physical activity levels in patients with IRD, as well as their impact on fatigue, Gray and colleagues reexamined data from their personal exercise program intervention with the addition of accelerometer data. Overall physical activity was assessed through vector magnitude, a measure of the device’s acceleration. An “intensity gradient” was calculated to describe the time spent at different intensity levels, with a lower value meaning more even distribution, the researchers wrote.
Step count and other metrics were also used to calculate participants’ levels of moderate-vigorous physical activity, which the researchers noted is a common government guideline. Accelerometer data was compared with fatigue levels, measured with the Chalder Fatigue Scale and Fatigue Severity Scale, at baseline and 6 months of follow-up.
The analysis included 337 participants with IRDs (mean age, 57.9 years), 191 of whom had rheumatoid arthritis. After adjustment, overall physical activity was negatively associated with Chalder Fatigue Scale score (B-coefficient = –0.88; 95% CI, –0.12 to –1.64), according to the researchers. Intensity gradient was also negatively associated with Fatigue Severity Scale score (B-coefficient = –1.16; 95% CI, –2.01 to –0.31).
Gray and colleagues additionally noted greater improvements on both fatigue scores among participants with greater overall physical activity, as well as superior benefit on the Fatigue Severity Scale among those with sufficient moderate-vigorous physical activity and higher step counts.
In all, 68.4% of study participants had insufficient moderate-vigorous physical activity, defined as spending 150 minutes per week or less taking more than 80 steps a minute, according to the researchers.
“The main thing for us is, when taken together with the LIFT trial, that physical activity is low in people with IRDs,” Gray said. “We need to try and promote — in a sensible way and avoiding boom and bust patterns — this as much as possible.
“We need to try and explore the underlying mechanisms in more depth,” he added. “We need to try and explore the optimal physical activity prescription in trials for people with IRDs — ie, what components, such as volume, intensity, patterns, etc. — are most important for which people. So, taking this work and developing a more personalized approach based on people clinical symptoms.”
For more information:
Stuart R. Gray, PhD, can be reached at stuart.gray@glasgow.ac.uk; X (Twitter): @DrStuGray.
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